Wharton Jelly Mesenchymal Stromal Cells as GVHD Prophylaxis

Inclusion criteria

• With AML/ALL/SMD/SMP or lymphoid neoplasm requiring allogeneic stem cell transplantation
• In complete response (CR) for AML/ALL or CR,partial response (PR) or non pre-treated for SMD/SMP and lymphoid neoplasm
• Without a HLA matched related donor available and with identification of a haploidentical donor (brother, sister, parents, adult children or cousin)

With usual criteria for HSCT:

• ECOG ≤ 2
• No severe and uncontrolled infection
• Cardiac function compatible with high dose of cyclophosphamide
• Adequate organ function: ASAT and ALAT ≤ 2N, total bilirubin ≤ 1.5N, creatinine clearance ≥30ml/min (except if those abnormalities are linked to the hematological disease)

• Requiring a RIC or non myeloablative conditioning:

(i) >50 years old; (ii) heavily pre-treated; (iii) Comoribidities according to Sorror et al. Blood 2005;106(8):2912-9, notamment HCT/CI≥ 3 (JAMA. 2011 Nov 2;306(17):1874-83).

• With health insurance coverage (bénéficiaire ou ayant droit)
• Understand informed consent or optimal treatment and follow-up
• Contraception methods must be prescribed during all the duration of the research and using effective contraceptive methods during treatment and within 12 months for women of childbearing age and 6 months for men of childbearing age after the last dose of cyclophosphamide

Exclusion criteria

• History of Cancer in the last 5 years
• Uncontrolled infection: Seropositivity for HIV or HTLV-1 or active hepatitis B or C defined by a positive PCR HBV or HCV and hepatic cytolysis due to HBV
• Uncontrolled coronary insufficiency, recent myocardial infarction <6 month, current manifestations of heart failure, uncontrolled cardiac rhythm disorders, ventricular ejection fraction <50%
• Pulmonary failure with DLCO<50%
• Addition of immunosuppressant treatment for GVHD prophylaxis (except immunosuppressant allowed per protocol)
• Renal failure with creatinine clearance <50ml / min
• Pregnancy (β-HCG positive) or breast-feeding
• Any debilitating medical or psychiatric illness which would preclude the realization of the SCT or the understanding of the protocol
• Under protection by law (tutorship or curatorship)
• Unwilling or unable to comply with the protocol